影像学评价长骨朗格汉斯细胞组织细胞增多症

目的探讨长骨朗格汉斯细胞组织细胞增多症(LCH)的影像学表现。方法回顾性分析7例经手术病理证实的LCH患者的综合影像学资料。7例均接受X线平片检查,6例接受CT,4例接受MR,6例接受ECT检查。分析各种影像学检查的表现和诊断价值。结果共8处长骨病灶,7处位于骨干部,1处在干骺端,X线平片和CT示8处病灶均表现为溶骨性骨质破坏,其中6处边界清楚,2处周缘见少许骨质增生;6处周围骨膜增生明显,其中2处表现为多层骨膜增生,4处病灶旁可见骨膜新生骨。4处病灶呈T1WI低-等信号,T2WI上呈均质或不均质高信号,病灶周围均见明显骨髓水肿和软组织肿胀。MRI显示软组织肿块2处。ECT示6例共7处病灶均表现为放射性浓聚区。结论长骨LCH影像学表现有一定特征性,应用综合影像学检查可更好地诊断。

Imaging evaluation of Langerhans cell histiocytosis in long bone

Objective To explore the imaging characteristics of Langerhans cell histicytosis (LCH) in long bone. Methods Imaging data of 7 patients with LCH confirmed by surgical pathology were analyzed. X-ray examination was performed in all cases, CT scan in 6, MR in 4 and ECT in 6 cases. The manifestations and value of different imaging methods were analyzed. Results Seven cases had 8 in long bone lesions, 7 located in diaphysis and 1 in metaphysic. Osteolytic bone destruction was found with X-ray and CT. Sclerosis could be seen in 2 of 6 lesions with sharp borders. There were 6 lesions with obvious periacetabular periosteum hyperplasia. Multilayer periosteum hyperplasia was detected in 2 lesions and periosteal new bone in 4 lesions. MRI demonstrates hypo- or iso-intensity on T1WI and homogeneous or inhomogeneous high signal on T2WI, as well as bone marrow edema and soft tissue. Lesions were all characterized by radioactive concentration area on ECT. Conclusion Imaging findings of LCH in long bong have certain characteristics. Combination of various imaging methods is helpful to correct diagnosis.